Association between electronic nicotine delivery systems use and risk of stroke: a meta-analysis of 1,024,401 participants

Awad, Kamal; Mohammed, Maged; Martin, Seth S.; Banach, Maciej

doi:10.5114/aoms/171473

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…Similarly, heavy alcohol consumption was associated with an increased risk of stroke, whereas light-moderate alcohol intake was associated with a decreased risk of stroke ( 10 ). Smoking or electronic nicotine delivery systems use have also been shown to be associated with the risk of stroke ( 40 , 41 ), although the association between serum nicotine levels and the risk of stroke remains unclear. Physical activity, on the other hand, is recognized as an effective means in stroke prevention ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Chen,

Liu,

et al. 2024

Front. Neurol.

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IntroductionThe relationship between oxidative balance score (OBS), an emerging integrative metric for assessing individual redox homeostasis, and the prevalence of stroke in the general population remains unknown. We aimed to explore these relationships in the National Health and Nutrition Examination Survey (NHANES). We investigated the relationship between the oxidative balance score (OBS) and stroke prevalence using NHANES data from 1999–2018.MethodsWe included eligible individuals from NHANES 1999–2018. OBS calculations were based on previously validated methods, and stroke diagnoses were based on self-reports in questionnaires. Multivariable logistic regression analyses were used to examine the independent associations of overall, dietary, and lifestyle OBS with stroke prevalence. In addition, restricted cubic spline (RCS), stratified analysis, and sensitivity analysis were used.ResultsWe included 25,258 participants aged 20–85 years, in which the prevalence of stroke was 2.66%. After adjusting for all confounders, overall and dietary OBS, but not lifestyle OBS, were inversely associated with the prevalence of stroke [odds ratios and 95% confidence intervals of 0.97 (0.96, 0.99) and 0.98 (0.96, 0.99) for overall and dietary OBS, respectively, both p < 0.05]. In addition, there was a dose-response relationship between overall and dietary OBS and stroke prevalence. The RCS showed that these relationships were linear. Stratified analyses indicated that socioeconomic status (SES) significantly influenced the relationship between all OBS and stroke prevalence.ConclusionDietary OBS, but not lifestyle OBS, had an inverse relationship with the prevalence of stroke in the general population. SES significantly influenced the protective effect of OBS against stroke. These findings emphasize the importance of integrated antioxidant properties from diet for stroke prevention.

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Section: Discussionmentioning

confidence: 99%

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Chen,

Liu,

et al. 2024

Front. Neurol.

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“…Awad et al conducted a meta-analysis that aimed to assess the relationship between EC usage and the risk of stroke in comparison to non-smokers. The authors reported that usage was significantly associated with an increased risk of stroke (OR: 1.52) when compared with non-users [ 51 ].…”

Section: Reviewmentioning

confidence: 99%

Unveiling the Impact of Electronic Cigarettes (EC) on Health: An Evidence-Based Review of EC as an Alternative to Combustible Cigarettes

Khanagar,

AlBalawi,

Alshehri

et al. 2024

Cureus

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Cigarette smoking has been considered a major public health concern due to its serious impact on health. However, smokers intending to quit may find long-term abstinence challenging. When smoking an electronic cigarette (EC), users can experience a sensation and taste similar to that of smoking a combustible cigarette. Therefore, manufacturers promote these products as a viable substitute for combustible cigarettes. However, several researchers report the serious health impacts experienced by EC users. Therefore, this review aims to examine the health impacts of EC use. Based on the findings of the research papers reported in the literature, the role of EC as a smoking cessation tool is unclear. Several researchers have also reported a significant association between EC usage among non-smokers at baseline and the future initiation of combustible cigarette smoking. EC use significantly impacts user health. The nicotine that is present in EC e-liquids can elevate blood pressure, resulting in blood vessel constriction and an increase in heart rate, ultimately leading the body to an ischemic condition, resulting in myocardial infarction (MI), stroke, and increased arterial stiffness. Researchers report a higher likelihood of prediabetes among EC users; its usage was associated with higher OR of having asthma attacks and higher OR of reporting depression and has an impact on birth outcomes among pregnant women. Men using EC are more likely to report erectile dysfunction than non-users. EC also has a significant impact on oral health, which includes periodontal diseases, mucosal lesions, irritation in the mouth and throat, reduced salivary flow, and an increased risk of developing cancer. The physical injury resulting from exploding EC is another health concern. The frequently burned areas included the hands, face, genitalia, and thighs. Marketers promote EC as an alternative to combustible cigarettes and a tool for quitting smoking. However, the Food and Drug Administration has not approved them for smoking cessation. EC can have a serious impact on the health of their users; hence, the findings of this paper have several implications, including the need for regulation of the sales and marketing of these products and educating the users on the impact of these products on their health and safety.

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“…A meta-analysis in August 2023 comprising 1024401 subjects confirmed increased stroke risk of roughly >50% in active ENDS users in comparison to non-users, purportedly due to collective effects of blood-brain barrier damage, blood pressure elevation, vascular repair impairment, endothelial dysfunction, and platelet activation. Since no such association was obtained for people who were not actively vaping, it was emphasized that smoking cessation is a linchpin for preventing stroke [ 84 ]. Concerning toxicity from individual components, the American Heart Association (AHA) implicated cardiac remodeling and arrhythmogenesis as a long-term consequence of nicotine use.…”

Section: Reviewmentioning

confidence: 99%

Understanding the Cardiovascular Fallout of E-cigarettes: A Comprehensive Review of the Literature

Chaturvedi,

Attia Hussein Mahmoud,

Isaac

et al. 2024

Cureus

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E-cigarettes (ECs) deliver chemicals, including nicotine. They can cause respiratory distress, addiction, cardiovascular effects, and death. More research is needed, especially regarding their impact on the cardiovascular system (CVS) and during pregnancy. Our article aims to fill this gap by summarizing studies elaborating upon the current impact of ECs and the components thereof on the CVS. Acute respiratory distress outbreaks, nicotine addiction, CVS effects, and deaths have been occasionally reported within this cohort, although these events are not uncommon with neighboring age groups. Randomized control trials implying ECs have some contribution toward quitting smoking have been studied. To regulate EC distribution, the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) have created key checkpoints. Additionally, taxation, pricing, age restriction, and media campaigns could be modulated to significantly reduce illicit sales. Education to the users, distributors, and regulators about this product can also play an aiding role in promoting responsible EC use. Another strategy about licensing could be employed, which could incentivize genuine resellers. The effects on CVS and child-bearing by ECs are grim, which calls for strict regulation, awareness, and avoidance by the teetotaler public. They may help individuals stop smoking but not without harming themselves. Strict regulations are necessary to prevent non-judicious use of these devices.

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Association between electronic nicotine delivery systems use and risk of stroke: a meta-analysis of 1,024,401 participants

Cited by 5 publications

References 10 publications

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Unveiling the Impact of Electronic Cigarettes (EC) on Health: An Evidence-Based Review of EC as an Alternative to Combustible Cigarettes

Understanding the Cardiovascular Fallout of E-cigarettes: A Comprehensive Review of the Literature

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